What We're Watching: April 16, 2019

NIGHT’S WATCH

A series of Congressional hearings to get to the bottom of high drug prices occurred last week. Three insulin drug manufacturers and three major PBMs were questioned by the House on the skyrocketing costs of insulin, and the Senate called on several companies during its third drug pricing hearing. Additionally, legislation requiring transparency around large drug price increases, rebates, samples and sales price data was approved.

What we’re saying: To create a healthier pharmaceutical marketplace, it is essential to treat all market competitors the same by maintaining a transparent and level playing field. Premier’s group purchasing organization (GPO) model, for instance, is an example of how a functional competitive market can and should work. It’s one reason why Premier has been named 12 times to Ethisphere’s World’s Most Ethical Companies list. We are determined to continue our work with committee leaders and the administration to achieve policies that boost competition to lower drug prices, eliminate drug shortages and bring value to healthcare providers, patients and the industry at large.

RACE TO THE THRONE

The Centers for Medicare & Medicaid Services (CMS) released the Medicare Shared Savings Program (MSSP) application form and timeline for ACOs looking to participate or renew participation in January 2020. Likewise, CMS is expected to open the application period for the second cohort of the Bundled Payments for Care Improvement (BPCI) Advanced Model Year 3 any day now.

What we’re saying: These models could mean future success for health systems, making these dates incredibly important. In fact, a recent study found the BPCI program succeeded in maintaining quality of care for vulnerable patients and lowered costs. As this administration continues to shift risk from government payers to private entities, healthcare providers are benefiting greatly from owning these models because they can control the premium dollar.

IN CASE YOU MISSED IT

• The Next Frontier: Clinically Driven, Employer-Customized Care
• Owning the Benefits of the Medicare Shared Savings Program
• Lahey Health Saves $22 Million with Premier
• Three Successful Approaches to Gainsharing in Bundles
• Cracking the Code on Physician Practice Performance

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members.